Author Affiliations: The Johns Hopkins University School of Medicine and Public Health, Baltimore, Maryland (Dr Robin); and Lions Aravind Institute of Community Ophthalmology–Aravind Eye Care System, Madurai, India (Mr Thulasiraj).
Cataract surgery has changed dramatically in the last few decades. The surgical indications then were visual disability and best-corrected acuity less than 20/200 as aphakic correction was barely acceptable. The problems with aphakic correction are well described by Woods.1 In less developed nations, if an aphakic patient looses or damages his spectacles, he is rendered functionally blind. The indications for cataract surgery have evolved to deal with even minimal vision loss as illustrated by Alfred Sommer's description of his postoperative experience where he has perfect vision the following day, allowing him to enjoy the cinema.2
Robin AL, Thulasiraj RD. Cataract Blindness. Arch Ophthalmol. 2012;130(11):1452–1455. doi:10.1001/jamaophthalmol.2013.765